甲苯磺酸瑞马唑仑在小儿麻醉诱导应用的前瞻性研究  

Prospective study on the application of remazolam toluene sulfonate in induction of anesthesia in children

作　　者：陈荣锋 蔡英敏 CHEN Rongfeng;CAI Yingmin(The Second Clinical School of Medicine,Xi'an Jiaotong University,Xi'an 710000;Department of Anesthesiology,Hanyin County Hospital of Traditional Chinese Medicine,Hanyin 725100,China)

机构地区：[1]西安交通大学医学部第二临床医学院,陕西西安710000 [2]汉阴县中医医院麻醉科,陕西汉阴725100

出　　处：《麻醉安全与质控》2025年第1期17-22,共6页Perioperative Safety and Quality Assurance

基　　金：陕西省体育局常规课题(2021001)。

摘　　要：目的拟通过对比丙泊酚,评估瑞马唑仑在小儿各类手术的安全性和有效性,为临床探索更理想的麻醉诱导方案提供参考。方法选取安康市汉滨区第一医院2021年11月至2023年1月择期行全麻手术的患儿120例为研究对象,采用随机数字表法将患儿分为丙泊酚2.5 mg/kg组(B组,n=40)、瑞马唑仑0.30 mg/kg组(R1组,n=40)、瑞马唑仑0.35 mg/kg组(R2组,n=40)。静脉注射舒芬太尼2 min以后,依次注射丙泊酚或瑞马唑仑及罗库溴铵;评估麻醉深度、肌松满意后行气管插管。记录不同麻醉诱导时间点的平均动脉压(MAP)、心率(HR)、脑电双频谱指数(BIS)值及改良警觉镇静评分(MOAA/S)等数据。观察入室时(T_(0))、第一次静注舒芬太尼前(T_(1))、第一次静注完舒芬太尼2 min时(T_(2))、静注完全麻诱导药物1 min时(T_(3))、静注完全麻诱导药物3 min时(T_(4))、气管插管进声门时(T_(5))、气管插管完成1 min时(T_(6))、气管插管完成3 min时(T_(7))8个不同时间节点的指标。结果R1、R2组在T_(3)、T_(4)时间点MAP高于B组,R1、R2组在T_(4)、T_(5)时间点HR高于B组,R1、R2组在T_(3)、T_(4)、T_(5)、T_(6)、T_(7)时间点BIS值高于B组,差异有统计学意义(P<0.05);R1、R2组术中血压下降发生率明显低于B组,差异有统计学意义(P<0.05)。结论瑞马唑仑可用于1~12岁患儿的快速顺序诱导插管全麻。瑞马唑仑注射后,患儿BIS值较高,认为BIS不适用于评估瑞马唑仑在麻醉诱导过程中的镇静深度。Objective To compare remazolam with propofol and observe its safety and effectiveness in pediatric surgeries for providing reference for a more ideal anesthesia induction program.Methods A total of 120 pediatric patients undergoing elective general anesthesia in the First Hospital of Hanbin District of Ankang City from November 2021 to January 2023 were selected and randomly divided into propofol 2.5 mg/kg group(group B,n=40),remazolam 0.30 mg/kg group(group R1,n=40)and remazolam 0.35 mg/kg group(group R2,n=40).Two minutes after intravenous sufentanil injection,propofol or remazolam and rocuronium were injected successive⁃ly;endotracheal intubation was performed after the depth of anesthesia and muscle relaxation were assessed.The mean arterial pressure(MAP),heart rate(HR),BIS value and MOAA/S score were recorded at different induction time points.Eight different time nodes were observed,at the time of entry(T_(0)),before the first infusion of sufentanil(T_(1)),2 min after the first infusion of sufentanil(T_(2)),1 min after the infusion of induction drugs for general anesthesia(T_(3)),3 min after the infusion of induction drugs for general anesthesia(T_(4)),when the tracheal intubation entered the glottis(T_(5)),and 1 min after the tracheal intubation was completed(T_(6)),3 min after endo⁃tracheal intubation is completed(T_(7)).Results The MAP of groups R1 and R2 at T_(3) and T_(4) was higher than that of group B,the HR of groups R1 and R2 at T_(4) and T_(5) was higher than that of group B,and the BIS value of groups R1 and R2 at T_(3),T_(4),T_(5),T_(6) and T_(7) was higher than those of group B,with statistical significance(P<0.05).The incidence of intraoperative blood pressure decrease in group R1 and group R2 was significantly lower than that in group B,and the difference was statistically significant(P<0.05).Conclusion Remazolam can be used for rapid sequential induction of intubation anesthesia in 1-12 years old patients.After injection of remazolam,BIS values are higher in pediatric patients.Thus BIS va

关 键 词：瑞马唑仑 不同剂量 麻醉诱导 有效性 安全性 

分 类 号：R61[医药卫生—外科学]